Providing IUSD Guidance and Supervision
The Risk Management Department provides guidance and supervision to staff performing duties applicable to Insurance and Risk Management.
Services We Provide
- Health & Welfare Employee Benefits for active and retired employees
- Provides terminated employees the opportunity to purchase an extension of medical coverage through COBRA and Assembly Bill AB528
- HIPPA Compliance
- Workers Compensation
- Provides information on students accident insurance plans
- Coordinates program involving employee and student safety
- Maintains required illness, accident and safety records and assists building inspectors
- Prepares financial projections in conjunction with the Budget process.
- Coordinates the District’s self-insured liability and Workers Compensation program and serves as the District’s representative on the Board of Directors to the insuring Joint Powers Authority (JPA).
Frequently Asked Questions:
When is Open Enrollment?
Open enrollment takes place annually beginning the last week of August and the first 3 weeks of September, with changes effective October 1st. You may enroll at other times during the year provided it is a qualifying event (e.g. termination of other coverage, newly eligible based on hours worked, acquisition of new dependent, etc.)
What constitutes an eligible dependent?
Eligible dependents are as follows:
- An employee’s legally married spouse, who is not legally separated from the employee, and is not a member on active duty with the Armed Forces;
- An employee’s unmarried child (including any step child legally adopted child, legally placed foster child, a child for whom legal guardianship is in force, or any other child whom a subscriber has a legal obligation to cover) who is under the age of 19 to age 25 (age varies by student status and plan – contact the Risk Management Office for specific questions), is not covered for benefits by the District as an employee, and is not a member on active duty with the Armed Forces, who is primarily dependent upon the employee for support and maintenance. Coverage is also available for disabled children under certain circumstances.
- Domestic Partner, defined as a person of the same or opposite sex who is no less than 18 years of age, unmarried and unrelated to the employee, shares a permanent residence with the employee, is financially interdependent with the employee and who has not been a member of another domestic partnership for the prior six months.
- Domestic Partner’s unmarried child(ren) as described in (b) above.
How do I add new dependents?
To add a newly eligible dependent you will need to complete the appropriate enrollment form and provide documentation of the dependent's eligibility (e.g. birth certificate, marriage certificate, divorce decree, adoption order, certificate of Domestic Partnership, etc.). Forms can be printed from the Web site, or secured at the District’s Risk Management Office. Completed forms along with supporting documentation must be submitted prior to coverage becoming effective.
Newly eligible dependents must be added within 31 days of their initial eligibility. If not added within 31 days, the dependent will not be eligible until the next Open Enrollment period.
Can I cover my dependent while he/she is attending college?
Yes, as long as the dependent is under age 23 to 25 (depending on the plan) and is enrolled as a full time student (9 units).
How do I add my Doctor to the provider network?
You can ask your doctor to contact the respective insurance provider as request to be contracted. You may also send a nomination to the respective insurance provider asking that they contact the physician to discuss contracting. This process can be accomplished by using the customer service contact information contained on this Web Site. However, not all providers will be contracted with all insurance providers as each physician and insurance provider reserves the right to make contracting decisions.
Can I self-refer to a specialist?
It depends on which plan of benefits that you participate in. For example in the Blue Shield plans you are free to self-refer to any specialist at any time. In the Kaiser and Cigna HMO plans you must be referred to the specialist by your Primary Provider. In most situations a specialist will not see or accept a new patient without a referral from a primary care physician regardless of the plan. Specialists have limited time to spend with each patient. Therefore, if a prospective patient self refers, the specialist has no data on symptoms, early diagnosis or preliminary treatment that may have already been provided or attempted. In all the plans, a female employee or dependent may have both a family practice doctor and OB/GYN as primary care providers. Children may elect either a family practice doctor or pediatrician.
Do our plans include mail order pharmacy benefits?
Yes. Blue Cross and Kaiser District’s plans offer mail order pharmacy benefits.
As a Kaiser member, can I submit or drop off enrollment changes directly at the doctor’s office or hospital?
No. The District requires that all enrollment changes be submitted through the Risk Management Office. This avoids eligibility and billing problems. If forms are not submitted through the Risk Management Office, the effective date of your coverage may be delayed.
What happens if my dependent college student terminates coverage mid-semester?
Coverage would terminate at the end of the month in which their college enrollment terminates and the dependent would be offered COBRA continuation benefits.